Low vitamin B₁₂ levels may predict the risk of ischemic stroke: A cross-sectional study

To examine serum vitamin B₁₂ concentrations in relation to the risk of ischemic stroke among hospitalized patients in the Department of Neurology.

We performed a cross-sectional study involving 2,212 inpatients discharged from the Department of Neurology of the First Affiliated Hospital of Chongqing Medical University, from January 2020 to January 2022. The results of laboratory assays such as serum vitamin B₁₂, homocysteine, and folate levels were measured. Logistic regression analysis was used to investigate the association between serum vitamin B₁₂ concentrations and ischemic stroke, with adjustment for a number of relevant demographic and lifestyle factors and comorbidities.

A total of 961 (43.4%) patients had an ischemic stroke. In the fully adjusted model, logistic regression analysis suggested a positive association between serum vitamin B₁₂ levels<150 pg/mL (aOR: 1.42; 95% CI 1.02-1.97; p = 0.035), serum vitamin B₁₂ 150-300 pg/mL (aOR: 1.37; 95% CI 1.11-1.68; p = 0.003) and the prevalence of ischemic stroke. Furthermore, an inverse association was observed between serum vitamin B₁₂ levels ≥ 900 pg/mL (aOR: 0.38; 95% CI: 0.19-0.77; p =0.007) and the prevalence of ischemic stroke. Moreover, the cut-off value of vitamin B₁₂ concentration was 316.4 pg/mL and the discrimination power of the score evaluated by AUC-ROC was 0.71 (95%CI 0.68-0.73, p<0.001) in the vitamin B₁₂ and ischemic stroke.

Findings suggest that low vitamin B₁₂ levels may predict the risk of ischemic stroke, early and timely supplementation of vitamin B₁₂ can improve the short-term prognosis of ischemic stroke patients.